MIAMI — Phillies reliever Jose Alvarado is back on the 15-day IL with left elbow inflammation, the same injury that sidelined him for just over a month from May 7 to June 9.
Alvarado said Sunday morning that the inflammation and swelling are in a different spot this time, more so the forearm area as opposed to the inside of the elbow.
The roster move was retroactive to July 7, meaning Alvarado could return on July 22 at the earliest. He will miss at least the Phillies’ first two series after the All-Star break at home against the Padres and Brewers.
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Alvarado first began feeling it during the final few days of June.
"It's been lingering for a while but I was able to throw," he said. "It's confusing, it's weird. I don't really know what it is anymore, the trainers don't really know what it is anymore, but we're taking it as inflammation.
"When I'm ready to pitch, I don't feel anything. It's weird because I throw hard, everybody sees my velo is normal, everything's consistent. Yesterday there was a lot of swelling. I don't want to push my arm like that. I've got 12 days rest."
Alvarado did not seem overly concerned Sunday morning in the visiting clubhouse at loanDepot Park but elbow injuries are always a worry, particularly with a pitcher who throws so hard with as much movement in his delivery as Alvarado, and especially when there's a recurrence this quickly.
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"There's always some concern but it's basically the same thing he had before, just some inflammation in the elbow and we've got to calm it down, knock it out," manager Rob Thomson said.
Alvarado has not had an MRI yet. Thomson said they'll first see how he responds to rest.
Alvarado's velocity hasn’t dropped — his fastball has averaged 99 mph since June 26 — but his control hasn’t been as sharp as it was prior to the first IL stint. Thomson thinks the elbow had something to do with the drop-off in strike-throwing, Alvarado has walked nine batters in 11⅔ innings and averaged 20 pitches per inning since returning from his first IL stint after not walking anyone in 14⅓ innings and averaging 15 pitches to start the season.
Gregory Soto will shift into the top left-handed relief role, just as he did the first time Alvarado was shelved. This time, however, lefty Matt Strahm can be used as more of a traditional reliever. Strahm had just shifted from the rotation to the bullpen the first time Alvarado was injured so there were restrictions on his usage. This time, Thomson said he'll feel more comfortable using Strahm on back-to-back days.